Anatomy and Physiology - Essay

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Key Terms & Concepts

Anatomy and Physiology 1H06, W2012

You should be able to describe and/or demonstrate an understanding of the following: *this is not an exhaustive list…

Cardiovascular Anatomy

• Heart: Location (Mediastinum), Base vs Apex, Major Landmarks (SVC, IVC, Pulm. Trunk, Aorta)

• Relational Anatomy: Structures Above, Below, Anterior & Posterior to Heart

• Surface Features: Anterior & Posterior (Atria, Ventricles, Great Vessels, Sulci)

• Sulci: Coronary Sulcus, Interventricular Sulcus

• Coronary Vasculature

o Coronary Arteries: Left (Circumflex, LAD), Right (Marginal, Posterior Interventricular)

o Coronary Veins: Left (Great Cardiac), Right (Small, Anterior, Middle), Coronary Sinus

• Pericardium: Fibrous, Perietal & Visceral (Serous/Epicardium) -> Cardiac Tamponade

• Heart Wall

o 3 layers (Epicardium, Myocardium, Endocardium)

o Differences between L&R Ventricle (Thickness, Workload)

o Inflammation: Epicarditis, Myocarditis, Endocarditis

• Chambers: Path of Blood Flow (2 Closed Circuits, Location of Oxy & Deoxy Blood)

• Heart Valves (what is their function?)

o Atrioventricular: Tricuspid vs Bicuspid (Mitral); Role of Chordae Tendineae & Papillary m.

o Semilumar: Pulmonary vs Aotic

o Fibrous Skeleton (3 Functions)

o Heart Sounds: Orientation of Heart determines direction of Echo (Valve Closure)

o Disease: Stenosis vs Prolapse; Murmur

Cardiovascular Development

• Postnatal (Adult) vs Fetal Circulation (where does vascular resistance differ and why?) • Fetal Circulation

o Specializations: Placenta, Umbilical Veins, Ductus Venosus, Foramen Ovale, Ductus Arteriosus, Umbilical Arteries

o What do they become in the adult?

o Where does Oxy & Deoxy Blood mix in the Fetus?

• Development of the Tubular Heart

o Major Stages: Fused Tube, Indentation, Elongation, Folding, Chamber Segregation

o Structures: Truncus Arteriosus, Bulbus Cordis, Ventricle, Atrium , Sinus Venosus

o What portion(s) of the adult heart do they contribute to?

• Division of Truncus Arteriosus

o Aorticopumonary (Spiral) Septum

o Role in proper development of Semilunar Valves (Stenosis, Enlargement)

o Persistent Trucus (the 3 chamber heart)

o Transposition of Great Vessels

• Patent Ductus Arteriosis

• Formation of Interatrial Septum (steps from Septum Primum -> Foramen Ovale)

o Operation of Valve of Foramen Ovale (before & after parturition)

o Patent Foramen Ovale (ASD)

• Formation of Interventricular Septum

o VSD

• Tetrology of Fallot (the big one!)

• Role of Endocardial Cushion

o Formation of Atrioventricular Valves

• CHD’s

o Shunt vs Obstruction

o Left to Right vs Right to Left

o Acyanotic vs Cyanotic

Case Study: Two Cardiology Cases

• Changes in vascular resistance at birth (Pulmonary vs Systemic Circuits)

• Adult vs Fetal (where is pressure higher, Right or Left side of Heart?)

• Factors Affecting Blood Flow (“the path of least resistance”)

o Flow = Δ Pressure / Resistance or Pressure = Flow x Resistance

o Pressure, Resistance (radius, length, viscosity)

o Greatest determinant of Resistance = radius (R ∝ 1/r4)

• Consequences of Patent Ductus Arteriosus (L to R Shunt)

• Consequences of Stenotic Pulmonary Valve (R to L Shunt via Foramen Ovale)

• Terms: Tachypneic, Murmur, Pulmonary Edema, Balloon Valvuloplasty

• Factors Affecting Pulmonary Vascular Resistance (PVR)

o Arterial pO2, Lung Vol., pH, Pulm. Vascular Remodeling

Cardiac Physiology

• Components of Cardiac Conduction System (& their roles) o SA Node, AV Node, Bundle of His, L & R Bundle...
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